Breaking Compliance News Blog

Compliance isn't just business… It’s personal.

Posted by Margaret Scavotto, JD, CHC on 1/17/14 4:22 PM

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Recent enforcement news added individual executives to the type of parties entering settlements with the government. Headlines typically devoted to organizations and their owners now include employees being held personally liable.

The former CEO of a long term care company agreed to pay $1 Million to resolve allegations that he caused the company to submit false claims to Medicare for services that were inflated or not medically necessary. The CEO is also excluded from participating in federal healthcare programs for 3 years. The company’s former CFO/Senior VP agreed to pay $20,000.

The government made it clear that this case is a warning of more to come. The Assistant Attorney General said: “Healthcare executives should lead by example and create cultures of compliance within their companies…. We will continue to hold health care executives personally accountable for their dealings with Medicare.” Inspector General Daniel R. Levinson made this clear as well: “Executives cheating taxpayers and patients—as alleged in this case—should beware of exclusion from Medicare, Medicaid, and all other federal health programs, as well as criminal and civil liability.”

This settlement is a reminder to all providers—and their executives and officers—of the importance of investing in a compliance program and compliant culture. Audits designed to detect false claims, and a hotline with reporting policies that encourage employees to report non-compliance can help prevent headlines like this.

Topics: Penalties and Enforcement, medical necessity, Culture of Compliance

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